Laserfiche WebLink
. o ���o��� <br /> Backwater Valve Installation Pro riNOV 1 3 2014 <br /> Installation Authorization Forrr�tlBLIC WORKS <br /> 1 Permission to Insoect. The Owner yrants permission to the Gty and its contractor to <br /> mspeci the plumbing and drainage c�the Owner's property for the purpose of <br /> determining whetner a backwater valve snould be installed. The City and J�vner will <br /> cooperate to determine a mutually agreeable time for the ir,spection. The inspectior, <br /> is at the City's sole cost <br /> 7. Backwater Valve Installation The City will review the results of the inspection and <br /> will determine whether a backvra,er valve should be installed By signing this <br /> authorization form, the OH-ner grants the City and its contraclor permission fo inslall <br /> the backevater valve if the Cily determines that a backwater valve should be mstalled. <br /> This installalion is at the Cdy's sole cost <br /> 3 Site Drainaqe. If inspection ef the property identifies that there are downspouts <br /> connected to the side sewer upstream of the proposed backwater valve location, the <br /> do�vnspouts�vill be disconnected or re-routed do��,nstream of the hackwater valve <br /> By signing this authorization, the Owner grants the City and ds contractor oermission <br /> to access the Owner's property to modify drainage connections Drainage <br /> modification is at the City's sole cost. <br /> OWNER(S): <br /> � <br /> L.�s- . <br /> Signature ^ Sgnatuie' <br /> S�' �������. I <br /> �,eaG�'� , --- - <br /> Prmled Name. Fnnled Narne <br /> �f� 3z- Cr',�,a�n ��� — <br /> Pnrted Address D'ate <br /> �-zS'- �s8- �n. L.S � ro_�c� /-�Z� 'l o � � <br /> —J�t— � 1)�a r . C U/�'j <br /> Phone Number E-mail <br /> I <br /> - --�- — i <br />